Teenage pregnancy is a major public health concern affecting more than 16 million girls and young women around the world. Teenage pregnancy is associated with unsafe abortions, infant and maternal mortality, high rate of unemployment, and school drop-outs . With increased awareness of the reproductive health consequences of teenage pregnancy, researchers and policy makers have concluded that teenage pregnancy and childbearing is a serious problem [3–6, 2, 7].
According to Worldatlas sub-Saharan African countries have the highest teenage pregnancy rates in the world: with Niger leading with 203.6 births per 100,000 teenage women, followed by Mali (175.4) and Angola (166.7), while Uganda is ranked number 14 at 114.8. Early childbearing carries particular risks, including dropping out of school, abandoning babies and obtaining illegal abortion that may result into death. Lillian & Mumbango  revealed that teenage pregnancy and childbearing is a serious social problem that is linked to the spread of HIV/AIDS, sexual abuse, neglect, and abortions as well as infant and maternal mortality. Their results showed that teenage pregnancy was influenced by generation, region, highest educational level, socio-economic status and cultural factors. This finding is consistent with the studies conducted by other scholars [9–11].
Teenage pregnancy is associated with various socioeconomic outcomes. Studies indicate that teens who become pregnant also tend to miss out on education. For example, young people who become parents while in their teens are much more likely than their
classmates who postpone childbearing to have their education truncated. Furthermore, the younger the parent at birth, the greater the educational setback. It is also likely that dropout rates will be high among girls who became pregnant during teenage.
Teenage mothers face psychosocial problems. Indeed, Kaye found that young adolescents reported anxiety and loss of self-esteem when they conceived. They also indicated having difficulty in accessing financial, moral and material support from parents or partners and stigmatization by health workers when they sought care from health facilities. Despite all the challenges, teenage mothers hardly have appropriate maternity services particularly teenager-friendly antenatal services.
The low use of contraception has been associated with high fertility, which remains a public health concern that should be averted. In addition to the unwanted/ early/ teenage pregnancies, these young people are also at a high risk of HIV infection and infection from other STIs . Researchers conclude that there is a need for an integrated approach to curb teenage pregnancy. Atuyambe et al  concluded that pregnant teenagers in Wakiso district lack basic needs like shelter, food and security. They also face relational problems with families, partners and the community. Several social factors such as religious beliefs, idleness and economic factors have been identified as factors contributing to early pregnancy [17–23].
The government of Uganda has taken several measures to address teenage pregnancy. Some of the policies and strategies include the National Strategy to end Child Marriage and Teenage pregnancy . This strategy was introduced in 2017 with the aim of providing guidance on the design and implementation of programmes that contribute to eliminating child marriage and teenage pregnancy. Others include the National Adolescent Health Policy, and the National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights. In spite of government’s efforts, teenage pregnancy rates remains high[26, 27]. Due to insufficient funding most government policies are not fully operationalized .
According to UBOS , one out of four (24.8%) girls aged 15—19 years have either a child or were pregnant at the time of the survey. Of the 15 regions considered in the 2016 Uganda Demographic and Health Survey, the percentage of women who had begun child bearing was lowest in Kampala (17%), followed by Kigezi (16%), Ankole (19%) and South Central (20%). The percentage was comparatively higher in North Central (30%), Busoga (21%), Bukedi (30%), Bugisu (28%), Teso (31%), Karamoja (24%), Lango (28%), Acholi (24%), West Nile (22%), Bunyoro (29%) and Tooro (30%). The highest percentage was among the women in Island districts where the level was as high as 48%. The percentage for both Island and Mountain districts was 31%, which is well above the national average (24.8%). This relatively high percentage generated research interest and need to investigate factors influencing teenage pregnancy in the two areas. The areas also have poor accessibility owing to steep terrain and sub-optimal water transport network in the mountain and island districts respectively. These conditions make the areas hard-to-reach and could exacerbate difficulty in accessing pregnancy-related care. It is against this background that this study seeks to establish the factors influencing teenage pregnancy in Uganda Lake Victoria Island/shoreline area and mountain districts.